Nigeria’s current diphtheria outbreak poses significant risks, with over 4,700 confirmed cases, according to a recent epidemiological report by the World Health Organization (WHO). The WHO has classified Nigeria as a high-risk country for diphtheria, a concerning revelation in the face of a second wave of the outbreak.
According to the report, the WHO highlighted that between June 30 and August 31, 2023, Nigeria recorded an unusual increase in the number of confirmed diphtheria cases. During this period, the country reported a total of 5,898 suspected cases from 59 Local Government Areas (LGAs) in 11 states, with a striking 99.4 percent of suspected cases reported from Kano, Katsina, Yobe, Bauchi, Kaduna, and Borno.
This outbreak is not an isolated occurrence; Nigeria previously experienced a first wave of diphtheria cases between January 1, 2023, and May 22, 2023. The report further highlights that there is an increased risk of transmission, with clusters and outbreaks reported in newly affected LGAs.
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Low vaccination coverage adds to the challenge
In response to the concerning surge in diphtheria cases, the WHO has called for a comprehensive strategy. The organization emphasized the importance of adhering to safety measures, effective public health measures, and vaccination campaigns.
The report provides a detailed breakdown of the 8,353 suspected cases, revealing that 56.5 per cent (4,717 cases) were confirmed, including those with lab confirmation, epidemiological linkage, and clinical compatibility. However, 1,857 cases (22.2 per cent) were ruled out as incompatible with diphtheria, and 1,048 cases (12.5 per cent) are still pending classification, with 731 cases (8.8 per cent) having unknown diagnoses.
Of particular concern is the age distribution of confirmed cases, with 73.5 percent aged 1 – 14 years, including 699 in the 0-4 age group, 1,505 aged 5-9 years, and 1,262 aged 10 – 14 years. More alarmingly, only 22.8 percent of the confirmed cases were fully vaccinated against diphtheria, while 6.3 percent had partial vaccination, and 59.4 percent were unvaccinated.
Urgent need for Immunisation
The WHO’s report underscores the critical importance of vaccination in curbing the diphtheria outbreak. With low national coverage (57 percent) of the Pentavalent vaccine (Penta 3) administered in routine immunization, Nigeria faces significant challenges in achieving herd immunity.
The report emphasises the need for a robust response that includes vaccination response, enhanced surveillance for early case detection, case management, and risk communication. These efforts are being coordinated by the Nigeria Centre for Disease Control (NCDC) in collaboration with the WHO and other partners.